23
PARTS REQUEST FORM
Paradigm
Health & Wellness
, Inc.
EMAIL THIS FORM WITH YOUR RECEIPT OF PURCHASE TO
*
NAME:
_____________________________________________________________________________________
ADDRESS:
__________________________________________________________________________________
CITY:
________________________
STATE:
_____________
ZIP:
_______________________________________
TELEPHONE:
(Day)
______________________________________________________________________
(Night)
_____________________________________________________________________
SERIAL#:
___________________________________________________________________________________
MODEL#:
___________________________________________________________________________________
PURCHASE DATE:
___________________________________________________________________________
PLACE OF PURCHASE:
_______________________________________________________________________
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
This form can also be faxed to #: 626-810-2166
PART #
DESCRIPTION
QTY
Содержание 900XL
Страница 5: ...3 LABEL PLACEMENT...
Страница 8: ...6 OVERVIEW DRAWING...
Страница 11: ...9 HARDWARE TOOLS PACK...